Evidence map›Paper›PMID 31695249›Full record

ReviewJournal of clinical and experimental hepatology

Systemic Therapy for Advanced Hepatocellular Carcinoma: An Update of a Rapidly Evolving Field.

Iliana Doycheva, Paul J Thuluvath

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 1 pooled it
4.3field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Iliana DoychevaInstitute for Digestive Heath and Liver Disease, Mercy Medical Center, Baltimore, MD, USA.
Paul J ThuluvathInstitute for Digestive Heath and Liver Disease, Mercy Medical Center, Baltimore, MD, USA.
Mercy Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hepatocellular carcinoma (HCC) incidence and mortality have shown an unfavorable upward trend over the last two decades, especially in developed countries. More than one-sixth of the patients have advanced HCC at presentation. Systemic therapy remains the treatment of choice for these patients. Current options include tyrosine kinase inhibitors (TKIs) and immunotherapy. This review aims to summarize current knowledge on the rapidly evolving field of systemic therapy with several newly approved medications over the last year. Sorafenib remains one of the first-line treatment choices for patients with hepatitis C etiology, intermediate to advanced HCC stage, and Child-Pugh class A. Lenvatinib is the other first-line drug that might have better efficacy in non-hepatitis C etiologies and advanced HCC without portal vein thrombosis. Patients intolerant to first-line therapy might benefit from immunotherapy with nivolumab or pembrolizumab. In those who fail first-line therapy, the choice should be based on the side effects related to previous treatment, performance status, and underlying liver dysfunction. Ongoing studies are investigating immunotherapy alone or immunotherapy in combination with TKIs as first-line therapy. Several second-line options for combination systemic therapy and systemic plus local-regional treatment are under investigation. Future studies should focus on identifying reliable biomarkers to predict response to therapy and to better stratify patients at high risk for progression. Multidisciplinary approach is pivotal for successful outcomes in patients with advanced HCC.

Indexed as

AFP, alpha-fetoproteinATP, adenosine triphosphateBCLC, Barcelona Clinic Liver CancerCI, confidence intervalcombination therapyCTLA-4, cytotoxic T lymphocyte-associated antigen-4CTP, Child-Turcotte-PughECOG, Eastern Cooperative Oncology GroupEGFR, epidermal growth factor receptorFDA, Food and Drug AdministrationFGFR, fibroblast growth factor receptorHBV, hepatitis B virusHCCHCC, hepatocellular carcinomaHCV, hepatitis C virusHR, hazard ratioimmunotherapyirAE, immune-related adverse eventsLRT, local-regional therapyLT, liver transplantationOS, overall survivalPD-1, programmed cell death-1PDGFR, platelet-derived growth factor receptorPFS, progression-free survivalRCT, randomized controlled trialRTK, receptor tyrosine kinasesystemic therapyTACE, transarterial chemoembolizationTEAE, treatment-emergent adverse effectTKI, tyrosine kinase inhibitorTTP, time to progressionVEGFR, vascular endothelial growth factor receptor

Identifiers

PMID31695249
PMCPMC6823698
OpenAlexW2964966581

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.